Menopause Diagnosis

Key Takeaways

Menopause is diagnosed retrospectively following 12 consecutive months without menstruation, and typically based on an evaluation of reported symptoms.
Healthcare professionals may perform a pelvic examination, use Quality-Of-Life scales, or hormonal tests where other conditions are suspected.
Conditions such as depression, thyroid disorders, endometriosis, ovarian cysts, gynecological cancers, or even vitamin deficiencies, can mimic menopause symptoms.

What is it?

Typically, a diagnosis of menopause involves a comprehensive evaluation of your reported symptoms and changes in your menstrual cycle, often confirmed after 12 consecutive months without menstruation. This process is typically a retrospective diagnosis, where healthcare professionals rule out other potential causes for the absence of menstruation.

Tests & Scales

Healthcare professionals may perform a pelvic examination to check for vulvovaginal atrophy (VVA), which supports a menopause diagnosis. They may also use Quality-Of-Life (QOL) scales to assess the severity of your symptoms and their impact on your quality of life.

QOL scales can be general, menopause specific, or combined. General scales include: The 36-Item Short Form Health Survey (SF-36) and The Euro Quality of Life (EuroQOL) 5 Dimension Scale (EQ-5D). Menopause-specific scales include: The Greene Climacteric Scale (GCS), The Women’s Health Questionnaire (WHQ), The Menopause Rating Scale (MRS), and The Cervantes Scale (or Cervantes Short-Form Scale (Cervantes-SF)). Combined scales include: The Utian Quality of Life (UQOL) scale and The Menopause-specific Quality of Life (MENQOL) Questionnaire).

While QOL scales capture the multi-dimensional nature of menopausal symptoms and a woman’s general health, they also capture a woman’s perception of her life status within her culture and value system, influenced by her goals, expectations, and concerns. This information helps to provide valuable information for personalized treatment and management plans.

More thorough evaluations might be necessary when experiencing irregular menstrual cycles or taking specific medications. Hormone tests like Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Anti-Müllerian Hormone (AMH), estradiol—a major form of estrogen, and testosterone are rarely required to diagnose menopause in women over 45 years as hormones constantly fluctuate. Such tests are also unlikely to alter the course of treatment.

However, some of these tests, like FSH and estradiol, are crucial for women experiencing symptoms of Premature Ovarian Insufficiency (POI) or premature and early menopause, which occurs before age 40 and 45, respectively. In these cases, elevated FSH levels and decreased estradiol confirmed in two separate tests 4-6 weeks apart can help with a diagnosis.

Last, menopause home test kits do not typically provide a definitive menopause diagnosis. These tests may provide information about hormone levels, such as FSH, LH, and estradiol from urine or blood samples. The results can be used to inform your next diagnostic steps, such as seeing a healthcare professional for an accurate diagnosis.

Similar Conditions

Other conditions, such as depression, thyroid disorders, endometriosis, ovarian cysts, gynecological cancers, or vitamin deficiencies, can display symptoms resembling those of menopause. Blood tests like Complete Blood Counts (also known as Full Blood Counts), ferritin levels, Thyroid-Stimulating Hormone (TSH), inhibin A, inhibin B, or Antral Follicle Count (AFC), Cancer Antigen 125 (CA125) can help rule out these conditions. When a woman is experiencing emotional symptoms like anxiety, low energy, or mood swings, it is essential to determine whether these are primary conditions or exacerbated by hormonal changes. Your detailed medical history can offer valuable clues in differentiating these scenarios.

To learn more, visit the Testing & Screening page.

Diagnosing menopause typically involves evaluating a woman’s symptoms and menstrual history, with confirmation after 12 consecutive months without menstruation. This retrospective diagnosis excludes other potential causes for menstrual changes. Pelvic examinations may be used to detect signs like VVA, while QOL scales assess symptom severity and impact on daily life, reflecting a woman’s life perception within her cultural and personal context. Hormone tests, such as FSH and estradiol, are rarely required for women over 45, but crucial for those with suspected POI or premature or early menopause. Additional tests may help rule out conditions with similar symptoms, ensuring an accurate diagnosis. Understanding the diagnostic process keeps you informed and facilitates the development of personalized treatment plans.

Frequently Asked Questions

How is menopause diagnosed?

Menopause is diagnosed primarily through clinical assessment. Healthcare professionals typically rely on a woman’s reported symptoms, particularly the cessation of menstrual periods for 12 consecutive months, including spotting.

Hormonal tests are rarely used to diagnose menopause, as the results are not always definitive, as hormone levels can fluctuate, and results are unlikely to alter the course of treatment. Hormonal tests may be used for women experiencing symptoms of Premature Ovarian Insufficiency (POI) or premature and early menopause. They may be also used where other conditions such as depression, thyroid disorders, endometriosis, ovarian cysts, gynecological cancers, or vitamin deficiencies are suspected.

How do you test for menopause?

Diagnosing menopause in women over 45 rarely relies on tests, as hormone levels can fluctuate, making results inconclusive and not typically affecting the course of treatment. For those with suspected Premature Ovarian Insufficiency (POI) or experiencing premature or early menopause, hormone tests like Follicle-Stimulating Hormone (FSH), estradiol, and Anti-Müllerian Hormone (AMH) may be used. Elevated FSH and low estradiol levels, confirmed in two separate tests about 4-6 weeks apart, can aid in diagnosis.

Additionally, low AMH levels might show diminished ovarian reserves. However, these tests (whether completed in a laboratory or using a menopause home test kit) are not definitive and should only be considered alongside a comprehensive review of symptoms and medical history for accurate diagnosis.

What could be mistaken for menopause?

Several health conditions can present with symptoms similar to menopause, leading to potential confusion or misdiagnosis. Thyroid disorders can cause symptoms like hot flashes, irregular periods, and mood swings, characteristic of perimenopause, the first stage of menopause. Polycystic Ovary Syndrome (PCOS) is another condition that leads to hormonal imbalances and irregular menstrual cycles.

Premature Ovarian Insufficiency (POI), which can occur in women under 40, shares several menopausal symptoms; however, a woman’s ovaries may still function to a degree. Additionally, chronic stress, depression, and vitamin deficiencies can influence menstrual cycles and mood, often misinterpreted as menopause symptoms. Therefore, when experiencing these symptoms, it’s important to consult a healthcare professional for a thorough evaluation to rule out other potential causes.

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